Multiple Metastatic Infection Related to Arteriovenous
Graft Infection in an ESRD Patient on Hemodialysis

Korean Journal of Nephrology 2010;29(6):824-828.

Multiple Metastatic Infection Related to Arteriovenous Graft Infection in an ESRD Patient on Hemodialysis

Seon-Ung Yun, M.D.1, Hae Jin Choi, M.D.1, So Young Kim, M.D.1, Hye Jin Choi, M.D.1, Hyun Sik Park, M.D.1, Byeong ju Bae, M.D.1, Hyun Kyun Ki, M.D.2 and Young-Il Jo, M.D.1

Division of Nephrology1 and Infectious Disease²
Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea

증례 : 인조혈관 동정맥루 감염에 동반된 다발성 전이성 감염

윤선웅1, 최혜진1, 김소영1, 최혜진1, 박현식1, 배병주1, 기현균2, 조영일1

건국대학교 의학전문대학원 내과학교실, 신장내과1, 감염내과2

Abstract

Arteriovenous vascular access infection associated with S. aureus bacteremia may cause metastatic complications, which relate to a poor outcome especially if proper diagnosis and treatment are delayed. We report a case of a 61-year-old male patient on maintenance hemodialysis who developed multiple metastatic infections associated with arteriovenous graft infection caused by methicillin-resistant Staphylococcus aureus (MRSA). At 7th hospital day, multiple metastatic infections, including osteomyelitis of clavicle, vertebral osteomyelitis, and tendinitis of the 5th finger proximal interphalangeal joint, were diagnosed by CT of chest, ultrasonography of hands, and whole body bone scan. Infected arteriovenous graft was removed and antibiotics was administrated for 18 weeks. Thereafter, MRSA bacteremia and clinical symptoms and signs related to metastatic infections were improved.

Key Words: Hemodialysis, Graft, Methicillin-Resistant staphylococcus aureus, Bacteremia